Adverse Childhood Experience Screening in the Primary Care Setting: The Importance of Resilience 11/7/19

Ever since Dr. Vincent Felitti led the 1998 study of adverse childhood experiences (ACEs), the impact of trauma on health outcomes has been more closely studied and more widely appreciated. Of course, in the realm of behavioral health, trauma has long been seen as a factor shaping more often than not a damaged sense of self and provoking deleterious symptoms. Yet, it was not until the lifelong […]

Maternal Depression: Why It Matters 10/24/2019

There has long been thought to be an intergenerational component as regards the impacts of maternal depression in leading to emotional and behavioral problems in children.  Youth with depressed mothers are more prone to developing depressive symptom profiles and in boys there are findings that indicate increased incidence of behavioral problems.   Various genetic and environmental […]

Psychotherapeutic Approaches 10/17/2019

Psychotherapy has a rich history and many traditions. Each school of thought draws from generations of theorists and practitioners. Over the past 40 years, there has been a growing movement to evaluate the effectiveness of therapy in general and specific models in particular. The expanding body of evidence has been helpful to confirm the long-standing […]

CBT for the Treatment of Insomnia 10/10/19

Insomnia is one of the primary presenting complaints in the primary care setting. It can be the only symptom the patient is reporting or it can be part of a constellation of symptoms related to a medical cause or mood or anxiety disorder. That, of course, has to be investigated first. Once that has been […]

Long Acting Injectable Antipsychotic Medications 10/3/2019

Antipsychotic medication can be delivered through long acting injectable (LAI) formulation. While these treatments are not typically prescribed by primary care doctors, primary care patients, both adolescents and adults, may need them. LAIs play a crucial role in treating psychotic symptoms. They can be used for individuals with schizophrenia, bipolar disorder with psychotic features, or […]

A Practical Review of Naltrexone 9/26/2019

Medication assisted treatment (MAT) has been increasingly shown in the literature to be helpful component of substance abuse treatment. The range of treatments has grown over the years, and certain treatments bring risks that limit their use in the primary care setting. Both methadone and buprenorphine, effective medications for opioid abuse, can be abused, have […]

A Practical Review of Eating Disorders 9/19/2019

Eating disorders are among the most dangerous psychiatric conditions. It is important to recognize and treat them as early as possible to prevent medical sequelae. The good news is that there are effective interventions, and here in San Diego, we have some of the most cutting-edge eating disorder treatment programs in the country. Here is […]

Collaborative Care 9/12/2019

Collaborative Care Across the country, there is a large treatment gap for children and adolescents facing mental health challenges;  up to 70 % of adolescents don’t receive care (SAMHSA). One of the ways to solve this crisis is to increase the capacity of primary care offices to provide mental health services. The integration of mental […]

Agitation in Autism Spectrum Disorder 9/5/2019

Autism spectrum disorder (ASD) is a developmental disability with increasing prevalence in the United States. The CDC estimates 1 in 59 children have ASD and is 4 times more common in boys than girls. The changing landscape makes is difficult to know true rates of healthcare utilization, but individuals and families impacted by ASD often […]

Weight Gain with Antidepressants 8/29/2019

  Many medications we prescribe for psychiatric conditions are associated with weight gain, including atypical antipsychotic medications, some mood stabilizer medications, and antidepressant medications. Some clinicians might view the risk of weight gain with antidepressant medications as a minor risk when viewing the seriousness of a patient’s depression. However, it is important to not add […]